Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review.

Depression Drug-resistant epilepsy Epilepsy Systematic review Vagal nerve stimulation

Journal

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 19 03 2020
accepted: 20 05 2020
pubmed: 12 6 2020
medline: 15 5 2021
entrez: 12 6 2020
Statut: ppublish

Résumé

Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epileptic patients. A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epileptic patients treated with VNS were included. Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies. Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epileptic patients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged.

Sections du résumé

BACKGROUND BACKGROUND
Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epileptic patients.
MATERIAL AND METHODS METHODS
A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epileptic patients treated with VNS were included.
RESULTS RESULTS
Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies.
CONCLUSIONS CONCLUSIONS
Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epileptic patients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged.

Identifiants

pubmed: 32524324
doi: 10.1007/s10072-020-04479-2
pii: 10.1007/s10072-020-04479-2
doi:

Substances chimiques

Antidepressive Agents 0

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3075-3084

Références

Chen Z, Brodie MJ, Liew D, Kwan P (2018) Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs a 30-year longitudinal cohort study. JAMA Neurol 75:279–286. https://doi.org/10.1001/jamaneurol.2017.3949
doi: 10.1001/jamaneurol.2017.3949 pubmed: 29279892
Spencer S, Huh L (2008) Outcomes of epilepsy surgery in adults and children. Lancet Neurol 7:525–537
doi: 10.1016/S1474-4422(08)70109-1
De Tisi J, Bell GS, Peacock JL et al (2011) The long-term outcome of adult epilepsy surgery, patterns of seizure remission, and relapse: a cohort study. Lancet 378:1388–1395. https://doi.org/10.1016/S0140-6736(11)60890-8
doi: 10.1016/S0140-6736(11)60890-8 pubmed: 22000136
Rathore C, Radhakrishnan K (2015) Concept of epilepsy surgery and presurgical evaluation. In: Epileptic disorders
Benbadis SR, Geller E, Ryvlin P, Schachter S, Wheless J, Doyle W, Vale FL (2018) Putting it all together: options for intractable epilepsy. Epilepsy Behav 88:33–38. https://doi.org/10.1016/j.yebeh.2018.05.030
doi: 10.1016/j.yebeh.2018.05.030
Ben-Menachem E, Mañon-Espaillat R, Ristanovic R et al (1994) Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. Epilepsia 35:616–626. https://doi.org/10.1111/j.1528-1157.1994.tb02482.x
doi: 10.1111/j.1528-1157.1994.tb02482.x pubmed: 8026408
George R, Salinsky M, Kuzniecky R et al (1994) Vagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study. Epilepsia. https://doi.org/10.1111/j.1528-1157.1994.tb02484.x
Elliott RE, Morsi A, Kalhorn SP, Marcus J, Sellin J, Kang M, Silverberg A, Rivera E, Geller E, Carlson C, Devinsky O, Doyle WK (2011) Vagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: long-term outcomes and predictors of response. Epilepsy Behav 20:57–63. https://doi.org/10.1016/j.yebeh.2010.10.017
doi: 10.1016/j.yebeh.2010.10.017 pubmed: 21144802
Orosz I, McCormick D, Zamponi N, Varadkar S, Feucht M, Parain D, Griens R, Vallée L, Boon P, Rittey C, Jayewardene AK, Bunker M, Arzimanoglou A, Lagae L (2014) Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 55:1576–1584. https://doi.org/10.1111/epi.12762
doi: 10.1111/epi.12762 pubmed: 25231724
Helmers SL, Wheless JW, Frost M, Gates J, Levisohn P, Tardo C, Conry JA, Yalnizoglu D, Madsen JR (2001) Vagus nerve stimulation therapy in pediatric patients with refractory epilepsy: retrospective study. J Child Neurol 16:843–848. https://doi.org/10.1177/08830738010160111101
doi: 10.1177/08830738010160111101 pubmed: 11732771
Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devinsky O (2004) Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology 62:258–261. https://doi.org/10.1212/01.WNL.0000103282.62353.85
doi: 10.1212/01.WNL.0000103282.62353.85 pubmed: 14745064
Kim M, Kim Y-S, Kim D-H, Yang TW, Kwon OY (2018) Major depressive disorder in epilepsy clinics: a meta-analysis. Epilepsy Behav 84:56–69. https://doi.org/10.1016/j.yebeh.2018.04.015
doi: 10.1016/j.yebeh.2018.04.015 pubmed: 29753295
Ajinkya S, Fox J, Lekoubou A (2020) Trends in prevalence and treatment of depressive symptoms in adult patients with epilepsy in the United States. Epilepsy Behav 105:106973. https://doi.org/10.1016/j.yebeh.2020.106973
doi: 10.1016/j.yebeh.2020.106973 pubmed: 32163889
Tombini M, Assenza G, Quintiliani L, Ricci L, Lanzone J, Ulivi M, di Lazzaro V (2020) Depressive symptoms and difficulties in emotion regulation in adult patients with epilepsy: association with quality of life and stigma. Epilepsy Behav 107:107073
doi: 10.1016/j.yebeh.2020.107073
Yuan T-F, Li A, Sun X, Arias-Carrión O, Machado S (2016) Vagus nerve stimulation in treating depression: a tale of two stories. Curr Mol Med 16:33–39. https://doi.org/10.2174/1566524016666151222143609
doi: 10.2174/1566524016666151222143609 pubmed: 26695696
Harden CL, Pulver MC, Ravdin LD, Nikolov B, Halper JP, Labar DR (2000) A pilot study of mood in epilepsy patients treated with vagus nerve stimulation. Epilepsy Behav 1:93–99. https://doi.org/10.1006/ebeh.2000.0046
doi: 10.1006/ebeh.2000.0046 pubmed: 12609137
Elger G, Hoppe C, Falkai P, Rush AJ, Elger CE (2000) Vagus nerve stimulation is associated with mood improvements in epilepsy patients. Epilepsy Res 42:203–210. https://doi.org/10.1016/S0920-1211(00)00181-9
doi: 10.1016/S0920-1211(00)00181-9 pubmed: 11074193
Rush AJ, Marangell LB, Sackeim HA, George MS, Brannan SK, Davis SM, Howland R, Kling MA, Rittberg BR, Burke WJ, Rapaport MH, Zajecka J, Nierenberg AA, Husain MM, Ginsberg D, Cooke RG (2005) Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial. Biol Psychiatry 58:347–354. https://doi.org/10.1016/j.biopsych.2005.05.025
doi: 10.1016/j.biopsych.2005.05.025 pubmed: 16139580
Rush AJ, George MS, Sackeim HA, Marangell LB, Husain MM, Giller C, Nahas Z, Haines S, Simpson RK Jr, Goodman R (2000) Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study∗∗See accompanying Editorial, in this issue. Biol Psychiatry 47:276–286. https://doi.org/10.1016/S0006-3223(99)00304-2
doi: 10.1016/S0006-3223(99)00304-2 pubmed: 10686262
Rush AJ, Sackeim HA, Marangell LB, George MS, Brannan SK, Davis SM, Lavori P, Howland R, Kling MA, Rittberg B, Carpenter L, Ninan P, Moreno F, Schwartz T, Conway C, Burke M, Barry JJ (2005) Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study. Biol Psychiatry 58:355–363. https://doi.org/10.1016/j.biopsych.2005.05.024
doi: 10.1016/j.biopsych.2005.05.024 pubmed: 16139581
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34. https://doi.org/10.1016/j.jclinepi.2009.06.006
doi: 10.1016/j.jclinepi.2009.06.006
Klinkenberg S, van den Bosch CNCJ, Majoie HJM, Aalbers MW, Leenen L, Hendriksen J, Cornips EMJ, Rijkers K, Vles JSH, Aldenkamp AP (2013) Behavioural and cognitive effects during vagus nerve stimulation in children with intractable epilepsy–a randomized controlled trial. Eur J Paediatr Neurol 17:82–90. https://doi.org/10.1016/j.ejpn.2012.07.003
doi: 10.1016/j.ejpn.2012.07.003 pubmed: 22878130
Ryvlin P, Gilliam FG, Nguyen DK, Colicchio G, Iudice A, Tinuper P, Zamponi N, Aguglia U, Wagner L, Minotti L, Stefan H, Boon P, Sadler M, Benna P, Raman P, Perucca E (2014) The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: the PuLsE (Open Prospective Randomized Long-term Effectiveness) trial. Epilepsia 55:893–900. https://doi.org/10.1111/epi.12611
doi: 10.1111/epi.12611 pubmed: 24754318 pmcid: 4283995
Radloff LS (1977) The CES-D Scale. Appl Psychol Meas 1:385–401. https://doi.org/10.1177/014662167700100306
doi: 10.1177/014662167700100306
Gilliam FG, Barry JJ, Hermann BP, Meador KJ, Vahle V, Kanner AM (2006) Rapid detection of major depression in epilepsy: a multicentre study. Lancet Neurol 5:399–405. https://doi.org/10.1016/S1474-4422(06)70415-X
doi: 10.1016/S1474-4422(06)70415-X pubmed: 16632310
Klinkenberg S, Majoie HJM, Van Der Heijden MMAA et al (2012) Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy. Clin Neurol Neurosurg 114:336–340. https://doi.org/10.1016/j.clineuro.2011.11.016
doi: 10.1016/j.clineuro.2011.11.016 pubmed: 22130047
Chavel SM, Westerveld M, Spencer S (2003) Long-term outcome of vagus nerve stimulation for refractory partial epilepsy. Epilepsy Behav 4:302–309. https://doi.org/10.1016/S1525-5050(03)00109-4
doi: 10.1016/S1525-5050(03)00109-4 pubmed: 12791333
Hoppe C, Helmstaedter C, Scherrmann J, Elger CE (2001) Self-reported mood changes following 6 months of vagus nerve stimulation in epilepsy patients. Epilepsy Behav 2:335–342. https://doi.org/10.1006/ebeh.2001.0194
doi: 10.1006/ebeh.2001.0194 pubmed: 12609210
Hallböök T, Lundgren J, Stjernqvist K, Blennow G, Strömblad LG, Rosén I (2005) Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood. Seizure 14:504–513. https://doi.org/10.1016/j.seizure.2005.08.007
doi: 10.1016/j.seizure.2005.08.007 pubmed: 16176878
Spindler P, Bohlmann K, Straub H-B, Vajkoczy P, Schneider UC (2019) Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy. Seizure 69:77–79. https://doi.org/10.1016/j.seizure.2019.04.001
doi: 10.1016/j.seizure.2019.04.001 pubmed: 30986721
Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP (1998) Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia 39:595–599. https://doi.org/10.1111/j.1528-1157.1998.tb01427.x
doi: 10.1111/j.1528-1157.1998.tb01427.x pubmed: 9637601
Kerr MP, Mensah S, Besag F, de Toffol B, Ettinger A, Kanemoto K, Kanner A, Kemp S, Krishnamoorthy E, LaFrance WC Jr, Mula M, Schmitz B, van Elst L, Trollor J, Wilson SJ, International League of Epilepsy (ILAE) Commission on the Neuropsychiatric Aspects of Epilepsy (2011) International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy. Epilepsia 52:2133–2138. https://doi.org/10.1111/j.1528-1167.2011.03276.x
doi: 10.1111/j.1528-1167.2011.03276.x pubmed: 21955156
Tombini M, Assenza G, Quintiliani L, Ricci L, Lanzone J, de Mojà R, Ulivi M, di Lazzaro V (2019) Epilepsy-associated stigma from the perspective of people with epilepsy and the community in Italy. Epilepsy Behav 98:66–72. https://doi.org/10.1016/j.yebeh.2019.06.026
doi: 10.1016/j.yebeh.2019.06.026 pubmed: 31299536
Dussaule C, Bouilleret V (2018) Psychiatric effects of antiepileptic drugs in adults. Gériatrie Psychol Neuropsychiatr du Viellissement 16:181–188. https://doi.org/10.1684/pnv.2018.0733
doi: 10.1684/pnv.2018.0733
Pisani LR, Nikanorova M, Landmark CJ, Johannessen SI, Pisani F (2018) Specific patient features affect antiepileptic drug therapy decisions: focus on gender, age, and psychiatric comorbidities. Curr Pharm Des 23:5639–5648. https://doi.org/10.2174/1381612823666170926103631
doi: 10.2174/1381612823666170926103631
Assenza G, Lanzone J, Dubbioso R et al (2020) Thalamic and cortical hyperexcitability in juvenile myoclonic epilepsy. Clin Neurophysiol
Pellegrino G, Mecarelli O, Pulitano P, Tombini M, Ricci L, Lanzone J, Brienza M, Davassi C, di Lazzaro V, Assenza G (2018) Eslicarbazepine acetate modulates EEG activity and connectivity in focal epilepsy. Front Neurol 9. https://doi.org/10.3389/fneur.2018.01054
Rolle CE, Fonzo GA, Wu W, Toll R, Jha MK, Cooper C, Chin-Fatt C, Pizzagalli DA, Trombello JM, Deckersbach T, Fava M, Weissman MM, Trivedi MH, Etkin A (2020) Cortical connectivity moderators of antidepressant vs placebo treatment response in major depressive disorder. JAMA Psychiatry 94305:397. https://doi.org/10.1001/jamapsychiatry.2019.3867
doi: 10.1001/jamapsychiatry.2019.3867
Vecchio F, Miraglia F, Curcio G, Della Marca G, Vollono C, Mazzucchi E, Bramanti P, Rossini PM (2015) Cortical connectivity in fronto-temporal focal epilepsy from EEG analysis: a study via graph theory. Clin Neurophysiol 126:1108–1116. https://doi.org/10.1016/j.clinph.2014.09.019
doi: 10.1016/j.clinph.2014.09.019 pubmed: 25449555
Vecchio F, Miraglia F, Curcio G, Altavilla R, Scrascia F, Giambattistelli F, Quattrocchi CC, Bramanti P, Vernieri F, Rossini PM (2015) Cortical brain connectivity evaluated by graph theory in dementia: a correlation study between functional and structural data. J Alzheimers Dis 45:745–756. https://doi.org/10.3233/JAD-142484
doi: 10.3233/JAD-142484 pubmed: 25613102
Parker CS, Clayden JD, Cardoso MJ, Rodionov R, Duncan JS, Scott C, Diehl B, Ourselin S (2018) Structural and effective connectivity in focal epilepsy. NeuroImage Clin 17:943–952. https://doi.org/10.1016/j.nicl.2017.12.020
doi: 10.1016/j.nicl.2017.12.020 pubmed: 29527498
Saletu B, Anderer P, Saletu-Zyhlarz GM (2010) EEG topography and tomography (LORETA) in diagnosis and pharmacotherapy of depression. Clin EEG Neurosci 41:203–210
doi: 10.1177/155005941004100407
Zhdanov A, Atluri S, Wong W, Vaghei Y, Daskalakis ZJ, Blumberger DM, Frey BN, Giacobbe P, Lam RW, Milev R, Mueller DJ, Turecki G, Parikh SV, Rotzinger S, Soares CN, Brenner CA, Vila-Rodriguez F, McAndrews MP, Kleffner K, Alonso-Prieto E, Arnott SR, Foster JA, Strother SC, Uher R, Kennedy SH, Farzan F (2020) Use of machine learning for predicting escitalopram treatment outcome from electroencephalography recordings in adult patients with depression. JAMA Netw Open 3:e1918377–e1918377
doi: 10.1001/jamanetworkopen.2019.18377
Romero-Osorio Ó, Gil-Tamayo S, Nariño D, Rosselli D (2018) Changes in sleep patterns after vagus nerve stimulation, deep brain stimulation or epilepsy surgery: systematic review of the literature. Seizure 56:4–8. https://doi.org/10.1016/j.seizure.2018.01.022
doi: 10.1016/j.seizure.2018.01.022 pubmed: 29414594
Murray BJ, Matheson JK, Scammell TE (2001) Effects of vagus nerve stimulation on respiration during sleep. Neurology 57:1523–1524
doi: 10.1212/WNL.57.8.1523
Benca RM, Obermeyer WH, Thisted RA, Gillin JC (1992) Sleep and psychiatric disorders: a meta-analysis. Arch Gen Psychiatry 49:651–668
doi: 10.1001/archpsyc.1992.01820080059010
Wu JC, Bunney WE (1990) The biological basis of an antidepressant response to sleep deprivation and relapse: review and hypothesis. Am J Psychiatry
Tononi G, Cirelli C (2012) Time to be SHY? Some comments on sleep and synaptic homeostasis. Neural Plast 2012:1–12. https://doi.org/10.1155/2012/415250
doi: 10.1155/2012/415250
Assenza G, Pellegrino G, Tombini M, di Pino G, di Lazzaro V (2013) Delta waves increase after cortical plasticity induction during wakefulness. Clin Neurophysiol 124:e71–e72. https://doi.org/10.1016/j.clinph.2014.09.029
doi: 10.1016/j.clinph.2014.09.029
Assenza G, Di Lazzaro V (2015) A useful electroencephalography (EEG) marker of brain plasticity: delta waves. Neural Regen Res 10:1216–1217. https://doi.org/10.4103/1673-5374.162698
doi: 10.4103/1673-5374.162698 pubmed: 26487841 pmcid: 4590226
Wolf E, Kuhn M, Normann C, Mainberger F, Maier JG, Maywald S, Bredl A, Klöppel S, Biber K, van Calker D, Riemann D, Sterr A, Nissen C (2016) Synaptic plasticity model of therapeutic sleep deprivation in major depression. Sleep Med Rev 30:53–62
doi: 10.1016/j.smrv.2015.11.003
Sanacora G, Zarate CA, Krystal JH, Manji HK (2008) Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders. Nat Rev Drug Discov 7:426–437
doi: 10.1038/nrd2462
Di Pino G, Pellegrino G, Capone F et al (2016) Val66Met BDNF polymorphism implies a different way to recover from stroke rather than a worse overall recoverability. Neurorehabil Neural Repair 30:3–8. https://doi.org/10.1177/1545968315583721
doi: 10.1177/1545968315583721 pubmed: 25896987
Sen S, Duman R, Sanacora G (2008) Serum brain-derived neurotrophic factor, depression, and antidepressant medications: meta-analyses and implications. Biol Psychiatry 64:527–532
doi: 10.1016/j.biopsych.2008.05.005
Goldschmied JR, Gehrman P (2019) An integrated model of slow-wave activity and neuroplasticity impairments in major depressive disorder. Curr Psychiatry Rep 21:30
doi: 10.1007/s11920-019-1013-4
O’Leary OF, Ogbonnaya ES, Felice D et al (2018) The vagus nerve modulates BDNF expression and neurogenesis in the hippocampus. Eur Neuropsychopharmacol 28:307–316. https://doi.org/10.1016/j.euroneuro.2017.12.004
doi: 10.1016/j.euroneuro.2017.12.004 pubmed: 29426666
Lang UE, Bajbouj M, Gallinat J, Hellweg R (2006) Brain-derived neurotrophic factor serum concentrations in depressive patients during vagus nerve stimulation and repetitive transcranial magnetic stimulation. Psychopharmacology 187:56–59. https://doi.org/10.1007/s00213-006-0399-y
doi: 10.1007/s00213-006-0399-y pubmed: 16767416
Hays SA, Rennaker RL, Kilgard MP (2013) Targeting plasticity with vagus nerve stimulation to treat neurological disease. Progress in brain research. Elsevier, In, pp 275–299
Capone F, Assenza G, Di Pino G et al (2015) The effect of transcutaneous vagus nerve stimulation on cortical excitability. J Neural Transm 122:679–685. https://doi.org/10.1007/s00702-014-1299-7
doi: 10.1007/s00702-014-1299-7 pubmed: 25182412
Kimberley TJ, Prudente CN, Engineer ND, Pierce D, Tarver B, Cramer SC, Dickie DA, Dawson J (2019) Study protocol for a pivotal randomised study assessing vagus nerve stimulation during rehabilitation for improved upper limb motor function after stroke. Eur Stroke J 4:363–377
doi: 10.1177/2396987319855306

Auteurs

Giovanni Assenza (G)

Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Mario Tombini (M)

Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Jacopo Lanzone (J)

Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Lorenzo Ricci (L)

Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Vincenzo Di Lazzaro (V)

Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Sara Casciato (S)

Epilepsy Surgery Center, IRCCS NEUROMED, Via Atinense 18, 86170, Pozzilli (IS), Italy.

Alessandra Morano (A)

Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.

Anna Teresa Giallonardo (AT)

Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.

Carlo Di Bonaventura (C)

Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.

Ettore Beghi (E)

Laboratory of Neurological Disorders, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

Edoardo Ferlazzo (E)

Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.

Sara Gasparini (S)

Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.

Loretta Giuliano (L)

Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.

Francesco Pisani (F)

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Paolo Benna (P)

Department of Neurosciences, University of Torino, Torino, Italy.

Francesca Bisulli (F)

IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Fabrizio A De Falco (FA)

Neurology Unit, Ospedale del Mare, Via Enrico Russo, Naples, Italy.

Silvana Franceschetti (S)

Department of Neurophysiopathology, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy.

Angela La Neve (A)

Department of Neurological and Psychiatric Sciences, Centre for Epilepsy, University of Bari, Bari, Italy.

Stefano Meletti (S)

Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Barbara Mostacci (B)

IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.

Ferdinando Sartucci (F)

Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Azienda Ospedaliero Universitaria Pisana and Neuroscience Institute, CNR, Pisa, Italy.

Pasquale Striano (P)

Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy.
Pediatric Neurology and Muscular Diseases Unit, IRCCS 'G. Gaslini' Institute, Genoa, Italy.

Flavio Villani (F)

Division of Clinical Neurophysiology and Epilepsy Center, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Umberto Aguglia (U)

Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.

Giuliano Avanzini (G)

Department of Neurophysiopathology, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy.

Vincenzo Belcastro (V)

Child Neuropsychiatry Unit, Department of Mental Health, ASST-Lariana, Como, Italy.

Amedeo Bianchi (A)

Division of Neurology, Hospital San Donato Arezzo, Arezzo, Italy.

Vittoria Cianci (V)

Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.

Angelo Labate (A)

Institute of Neurology, University Magna Graecia, Germaneto (CZ), Italy.

Adriana Magaudda (A)

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Roberto Michelucci (R)

IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.

Annapia Verri (A)

Department of Behavioural Neurology and Laboratory of Cognitive Behavioural Psychology, Fondazione Istituto Neurologico Casimiro Mondino, Pavia, Italy.

Gaetano Zaccara (G)

Regional Health Agency of Tuscany, Florence, Italy.

Vincenzo Pizza (V)

Neurophysiopatology Unit, S. Luca Hospital, Vallo della Lucania (SA), Italy.

Paolo Tinuper (P)

IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Giancarlo Di Gennaro (G)

Epilepsy Surgery Center, IRCCS NEUROMED, Via Atinense 18, 86170, Pozzilli (IS), Italy. gdigennaro@neuromed.it.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH